Submacular Hemorrhage

This chapter provides a focused overview of submacular hemorrhage (SMH) management when significant visual symptoms are present. Addressing the causes, pathogenesis, and natural course of SMH, the chapter emphasizes the critical importance of early intervention to prevent irreversible damage to the retina. Clinical features, diagnostic techniques, and examination methods for differentiating causes are discussed. The chapter covers contemporary treatment strategies, including intravitreal injections of anti-vascular endothelial growth factor agents, non-surgical pneumatic displacement, and pars plana vitrectomy (PPV) with various combinations of agents such as tissue plasminogen activator (tPA). Outcomes and controversies related to the efficacy of non-surgical pneumatic displacement versus PPV are also addressed, with expert insights provided based on the current evidence.